Kamarie Lee Larson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW10415 Issued in FL

Practice address

2705 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3047

Phone

(850) 737-6864

NPI assigned

Nov 8, 2020

Last updated

Jan 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 18, 2024 through Jun 18, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gulf Breeze Therapy, LLC

  • Clinical Social Worker
  • Gulf Breeze, FL
  • NPI 1376278606
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1629679303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FIRETHORN RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614318",
            "telephone_number": "850-737-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633047",
            "telephone_number": "850-737-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KAMARIE",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-08",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://gulfbreezetherapy.clientsecure.me",
            "affiliation": "N",
            "endpointDescription": "Client Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Messaging and document upload",
            "address_1": "913 Gulf Breeze Pkwy Ste 26B",
            "city": "Gulf Breeze",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325614731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://gulfbreezetherapy.clientsecure.me",
            "affiliation": "N",
            "endpointDescription": "Client Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2705 Gulf Breeze Pkwy",
            "city": "Gulf Breeze",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325633047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan J Laenger, MD
• Thomas Lampone, M.D.
• Landmark Recovery of Florida LLC
• Eric A Lane, ARNP
• Mary Jessica Langston, MS, ATC, LAT
• Nicole Latham
• Quintin Orville Law, MD
• Gregory Edmund Lebleu I, MD
• Lisa D. Ledkins, LMT
• Julie Potomski Lee, PA-C

• Clinical Social Worker in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.